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Socio-demographic factors associated to lack of immunization against hepatitis B in the Cohort of the Spanish AIDS Research Network (CoRIS)
S. Pérez-Cachafeiro1, P. Sobrino Vegas1, J.M. Miro2, I. Santos3, B. Clotet4, J. Berenguer5, P. Labarga6, F. Pulido7, P. Arazo8, J.A. Pineda9, S. Moreno10, CoRIS
1Instituto de Salud Carlos III, Centro Nacional de Epidemiología, Madrid, Spain, 2Hospital Clinic, Barcelona, Spain, 3Hospital Universitario de La Princesa, Madrid, Spain, 4Hospital Germans Trias i Pujol, Badalona, Spain, 5Hospital General Universitario Gregorio Marañón, Madrid, Spain, 6Hospital Carlos III, Madrid, Spain, 7Hospital Universitario 12 de Octubre, Madrid, Spain, 8Hospital Universitario Miguel Servet, Zaragoza, Spain, 9Hospital Universitario de Valme, Sevilla, Spain, 10Hospital Universitario Ramon y Cajal, Madrid, Spain
Background: Since the introduction of HAART, the importance of liver diseases, particularly hepatitis, has increased in HIV-infected patients. Therefore, its prevention becomes a major issue in this population. Our objective is to assess sociodemographic factors associated to lack of immunity against Hepatitis B virus in CoRIS.
Methods: CoRIS is a multicenter prospective cohort of 4,419 HIV seroprevalent ART-naïve patients seen at 31 centres in Spain (January 2004 - November 2008). We analysed the serologic status of 2.812 who had complete HBV serology at study entry. We defined patients as susceptible, natural immune (past infection) and vaccinated according to serology presented in graph 1. Sociodemographic factors associated with susceptibility were assessed by logistic regression.
Results: Whereas 5.8% of Coris patients were HBV-infected (AgHBs in serum), 36% were found to be still susceptible to HBV. Graph 1 shows CoRIS HBV serologic profile. Natural immunity is more frequent in IVDU and MSM. Older people (>40, ) and SubSaharan Africans do also present high prevalences of natural immunity (33% and 30% respectively).
[Serologic profile by transmission category]
Women [OR 1.55 (1.22 - 1.96)] are more susceptible to HBV than IVDU [OR 0.16 (0.12 - 0.22)], MSM [OR 0.49 (0.39 - 0.61)], SubSaharans [OR 0.18 (0.12 - 0.26)], Eastern Europeans [OR 0.40 (0.22 - 0.72)] and people aged>40 [OR 0.55 (0.44 - 0.69)].
Conclusions:
Our findings suggest that among HIV infected people in Spain, older persons, Eastern Europeans, Africans and IDUs are less susceptible to HBV infection. Females, heterosexuals, Western Europeans and LatinAmericans should be specially targeted in HBV vaccination programs.
Funding: ISCIII RD06/006
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